PHIL 235 BIOMEDICAL ETHICS EXAMS SCRIPT
ACTUAL QUESTIONS AND ANSWERS SURE A+
✔✔3 components of autonomous action - ✔✔1. Intentional
2. Understanding
3. Free of external influences
✔✔respect for autonomy - ✔✔The rational, mentally mature individuals right to make
decisions regarding their own life, obligates HCPs to allow patients to direct their own
health care even if non optimal.
✔✔Relational Approach to Autonomy in Health Care (Susan Sherwin) - ✔✔- Offers an
important set of concerns
- The usual method of obtaining informed consent falls short
- Root of problem is we conceive individuals as independent, self interested and self-
sufficient.
- Reality is autonomy can be enhanced or diminished based on socialization
experienced.
- People who are oppressed may not be as autonomous and we need to work towards
spending more time than usual providing relevant information.
✔✔Privacy, human rights, public policy & Law - Canadian HIV/AIDS legal network - ✔✔-
person revealing HIV (+) exposes self to discrimination and intolerance
, - patients need to have control over disclosure of diagnosis
- can result in significant losses: material & social
✔✔Privacy And confidentiality: - ✔✔An individuals right to control access to viewing and
touching intimate aspects of their bodies and revelation of intimate personal information
at their own discretion.
- Bodily privacy
- Information privacy
- Communication privacy
- territorial privacy
✔✔Confidentiality According to Mark Siegler - ✔✔- Traditional notion of confidentiality
does not exist, its systematically breached. A patient yelled at Siegler to ensure his
confidentiality. Siegler then investigated and found that 100s of HCPs reviewed the
patient's records including therapists students etc.
- This cant be reversed because better care is evolving and needs it
Siegler suggests
1. Need to know protocols for hospital staff
2. Patients should be informed confidentiality is changing
3. Patients should be given input on what may be shared.
- better care is perhaps bought at the expense of diminished confidentiality
more worried about people they know, not random staff finding stuff out
✔✔Telling the Truth to Patients - MACK LIPKIN - ✔✔When can truth telling be
suspended?
- Veracity/truth telling is a prima facie duty, not an absolute obligation
- Default you must tell the patient but what conditions should you not?
1. Culture
2. Fragile emotional state
3. Patient wouldn't understand
4. Benevolent deception (blissful ignorance)
LIPKINS POSITION
- Physicians should tell most patients the truth if they can understand and process it.
- A good physician can sense when they don't want to know
- Placebo truth/lies should be employed with caution (was the deception well intended)
- deception may be justified in dr-patient relationships so long as it is to the benefit of
the patient
✔✔Telling the Truth to Patients - David C. Thomasma - ✔✔-Telling the truth is the
default, yet veracity is a secondary value and can be suspended in favor of other values
such as survival and well being
- Thomasma focuses on
1. Context
2. Secondary nature of value of truth
3. Truth is necessary at some point to reach a cure
4. Withholding truth is temporary
ACTUAL QUESTIONS AND ANSWERS SURE A+
✔✔3 components of autonomous action - ✔✔1. Intentional
2. Understanding
3. Free of external influences
✔✔respect for autonomy - ✔✔The rational, mentally mature individuals right to make
decisions regarding their own life, obligates HCPs to allow patients to direct their own
health care even if non optimal.
✔✔Relational Approach to Autonomy in Health Care (Susan Sherwin) - ✔✔- Offers an
important set of concerns
- The usual method of obtaining informed consent falls short
- Root of problem is we conceive individuals as independent, self interested and self-
sufficient.
- Reality is autonomy can be enhanced or diminished based on socialization
experienced.
- People who are oppressed may not be as autonomous and we need to work towards
spending more time than usual providing relevant information.
✔✔Privacy, human rights, public policy & Law - Canadian HIV/AIDS legal network - ✔✔-
person revealing HIV (+) exposes self to discrimination and intolerance
, - patients need to have control over disclosure of diagnosis
- can result in significant losses: material & social
✔✔Privacy And confidentiality: - ✔✔An individuals right to control access to viewing and
touching intimate aspects of their bodies and revelation of intimate personal information
at their own discretion.
- Bodily privacy
- Information privacy
- Communication privacy
- territorial privacy
✔✔Confidentiality According to Mark Siegler - ✔✔- Traditional notion of confidentiality
does not exist, its systematically breached. A patient yelled at Siegler to ensure his
confidentiality. Siegler then investigated and found that 100s of HCPs reviewed the
patient's records including therapists students etc.
- This cant be reversed because better care is evolving and needs it
Siegler suggests
1. Need to know protocols for hospital staff
2. Patients should be informed confidentiality is changing
3. Patients should be given input on what may be shared.
- better care is perhaps bought at the expense of diminished confidentiality
more worried about people they know, not random staff finding stuff out
✔✔Telling the Truth to Patients - MACK LIPKIN - ✔✔When can truth telling be
suspended?
- Veracity/truth telling is a prima facie duty, not an absolute obligation
- Default you must tell the patient but what conditions should you not?
1. Culture
2. Fragile emotional state
3. Patient wouldn't understand
4. Benevolent deception (blissful ignorance)
LIPKINS POSITION
- Physicians should tell most patients the truth if they can understand and process it.
- A good physician can sense when they don't want to know
- Placebo truth/lies should be employed with caution (was the deception well intended)
- deception may be justified in dr-patient relationships so long as it is to the benefit of
the patient
✔✔Telling the Truth to Patients - David C. Thomasma - ✔✔-Telling the truth is the
default, yet veracity is a secondary value and can be suspended in favor of other values
such as survival and well being
- Thomasma focuses on
1. Context
2. Secondary nature of value of truth
3. Truth is necessary at some point to reach a cure
4. Withholding truth is temporary
